Spectrum of Congenital Heart Diseases in Early Childhood (1-60 months): Insights from a Sub-Himalayan Tertiary Care Centre

Background: Congenital heart disease (CHD) is a leading cause of birth defect-related mortality, with delayed diagnosis common in resource-limited regions.In India, gaps in CHD detection and care persist, especially in remote areas like Himachal Pradesh.This study evaluates the spectrum and outcomes of CHD in early childhood at a Sub-Himalayan tertiary care centre.Objective: To study the spectrum and outcomes of congenital heart disease (CHD) in children aged 1 month to 5 years in a tertiary hospital of sub-Himalayan region.Methods: This prospective observational study was conducted over a period of one year, from December 2023 to December 2024.Children aged 1-59 months with echocardiographically confirmed CHD were enrolled.Clinical details and outcomes were recorded during follow-up.Results: Seventy children (19.2per 1000) were diagnosed with CHD.Among them, 67% were infants, with a female preponderance (male: female ratio 0.9:1).Acyanotic lesions comprised 81%, most commonly ventricular septal defect (34%), atrial septal defect (28%), and patent ductus arteriosus (15%).Tetralogy of Fallot (14%) was the main cyanotic lesion.Congestive heart failure occurred in 35 children.Ten underwent surgery, and four deaths were recorded. Conclusion:CHD is a significant burden in early childhood, with prevalence of 19.2/1000 recorded in this cohort.It contributed to substantial morbidity (50%) and mortality (5.7%).